Social, economic, and health impact of the respiratory syncytial virus: a systematic search

Background: Bronchiolitis caused by the respiratory syncytial virus (RSV) and its related complications are common in infants born prematurely, with severe congenital heart disease, or bronchopulmonary dysplasia, as well as in immunosuppressed infants. There is a rich literature on the different aspects of RSV infection with a focus, for the most part, on specific risk populations. However, there is a need for a systematic global analysis of the impact of RSV infection in terms of use of resources and health impact on both children and adults. With this aim, we performed a systematic search of scientific evidence on the social, economic, and health impact of RSV infection. Methods: A systematic search of the following databases was performed: MEDLINE, EMBASE, Spanish Medical Index, MEDES-MEDicina in Spanish, Cochrane Plus Library, and Google without time limits. We selected 421 abstracts based on the 6,598 articles identified. From these abstracts, 4 RSV experts selected the most relevant articles. They selected 65 articles. After reading the full articles, 23 of their references were also selected. Finally, one more article found through a literature information alert system was included. Results: The information collected was summarized and organized into the following topics: 1. Impact on health (infections and respiratory complications, mid-to long-term lung function decline, recurrent wheezing, asthma, other complications such as otitis and rhino-conjunctivitis, and mortality; 2. Impact on resources (visits to primary care and specialists offices, emergency room visits, hospital admissions, ICU admissions, diagnostic tests, and treatments); 3. Impact on costs (direct and indirect costs); 4. Impact on quality of life; and 5. Strategies to reduce the impact (interventions on social and hygienic factors and prophylactic treatments). Conclusions: We concluded that 1. The health impact of RSV infection is relevant and goes beyond the acute episode phase; 2. The health impact of RSV infection on children is much better documented than the impact on adults; 3. Further research is needed on mid-and long-term impact of RSV infection on the adult population, especially those at high-risk; 4. There is a need for interventions aimed at reducing the impact of RSV infection by targeting health education, information, and prophylaxis in high-risk populations.

O processo de constituição e funcionamento de um Conselho Municipal dos Direitos do Idoso: o caso do município de Maringá-PR

O envelhecimento populacional é um processo que produz impacto nas relações sociais e nas políticas públicas. Os Conselhos de Direitos do Idoso surgem no cenário nacional como uma inovação institucional, para exercer controle democrático entre o Estado e a sociedade no tocante à pessoa idosa. Este trabalho propôs-se a olhar para o processo de constituição e funcionamento do Conselho Municipal dos Direitos do Idoso (CMDI) de Maringá, localizado no Estado do Paraná. Para tanto, realizamos entrevistas com conselheiros, que foram complementadas pela análise de documentos do CDMI de Maringá. O CDMI estudado não surgiu de um amplo movimento social em torno das questões do idoso. Ele decorreu de uma ação de técnicos da Secretaria de Assistência Social, que buscaram ativamente a interface com entidades do movimento social. Por sua vez, o Conselho parece se constituir como um campo de práticas, no qual tanto representantes do movimento social como representantes do governo vão constituindo significados para o que é ser conselheiro. Assim, convivem distintas acepções. De um lado, técnicos das diversas secretarias oscilam entre a ideia de que devem defender as posições de suas secretarias e da gestão municipal, e a de que, ao se tornarem conselheiros, devem se pautar pela defesa dos direitos do idoso. De outro, participantes que vão, em sua trajetória como conselheiros, descobrindo os potenciais da participação nas discussões de projetos e propostas relativos ao idoso. A pesquisa permitiu apreender, ainda, algumas tensões que atravessam o Conselho, como entre o ainda hoje indispensável apoio técnico-administrativo e político da Secretaria de Assistência Social e o sonho de uma maior autonomia frente ao Executivo, ou como a tensão entre um modo de ver a política do idoso como uma questão da assistência social ou como uma questão do direito. Por fim, a pesquisa nos permite reconhecer um grande potencial nessa dinâmica do Conselho, ressaltando-se entretanto, que tal trajetória deve muito ao decisivo apoio da gestão municipal.

The Spanish corporate structure through interlocking directorates

[EN] The aim of this paper is to determine to what extent globalization pressures are changing interlocking directorate networks modeled on continental capitalism into Anglo-Saxon models. For this purpose we analyse the Spanish network of interlocks, comparing the present structure (2012) with that of 1993 and 2006. We show how, although Spanish corporative structure continues to display characteristics of the continental economies, some major banks are significantly reducing industrial activity. Nevertheless, the financial organizations continue to maintain a close relationship with sectors such as construction and services. The analysis of the network of directorates shows a retreat in activity of industrial banking in Spain. Two large Spanish financial institutions, BSCH and La Caixa, continue to undertake activities of industrial banking in 2006, but this activity is significantly reduced in 2012. According to the theories on the role of the interlocking directorates, the companies in these sectors assure their access to banking credit by incorporating advisors from financial organizations to their board of directors. We cannot conclude that the structure of the Spanish corporate network has become a new case of Anglo-Saxon structure, but we got indications that are becoming less hierarchic as banks seem to slowly abandon centrality positions. This is especially salient if we compare the networks of 2006 and 2012, which show a continuing decrease of the role of banks and insurance companies in the network.

Promoção de Segurança Alimentar e Nutricional na Estratégia Saúde da Família: uma aproximação a partir da escuta de diferentes atores sociais

A garantia de Segurança Alimentar e Nutricional (SAN) remete à necessidade de ações intersetoriais que articulem as dimensões alimentar e nutricional, além da questão contemporânea da sustentabilidade e da perspectiva do direito humano à alimentação adequada. O setor saúde tem funções específicas e importantes que contribuem para o conjunto das políticas de governo voltadas para a garantia da SAN a população. Desta forma, ações promotoras de SAN devem ser desenvolvidas em todos os níveis de atenção do Sistema Único de Saúde, sendo a Atenção Básica à Saúde, por meio da Estratégia Saúde da Família (ESF), um campo privilegiado de implementação dessas ações, uma vez que está configurada como a porta preferencial de entrada dos usuários no sistema de saúde e como o centro norteador da rede de assistência. Este é um estudo exploratório e descritivo de abordagem qualitativa que teve como objetivo conhecer o que profissionais de equipes de saúde da Família, gestores dos âmbitos federal e municipal ligados à ESF, além de representantes de organizações da sociedade civil atuantes no campo da SAN entendem sobre SAN e sobre práticas promotoras de SAN na ESF. A construção das informações ocorreu por meio de entrevistas semi-estruturadas e grupos focais. Os profissionais referiram-se a SAN como a garantia de uma alimentação que atenda às necessidades nutricionais e que seja segura para o consumo, enquanto que entre os representantes da sociedade civil organizada e gestores predominou uma compreensão mais ampla da SAN. Os diferentes atores identificaram a ESF com um espaço promotor de SAN a partir do levantamento de ações já desenvolvidas ou que possam vir a ser desenvolvidas, porém as ações citadas encontram-se majoritariamente ligadas à dimensão nutricional da SAN. Os atores referiram um conjunto de problemas estruturais que desencadeiam dificuldades no cotidiano da organização dos serviços e das práticas dos profissionais e consequentemente na execução de ações promotoras de SAN nessa estratégia. Este trabalho levantou a necessidade de difundir a interdependência entre saúde e SAN entre gestores e profissionais ligados à ESF para que estes possam identificar melhor nas ações dos serviços de saúde elementos promotores da SAN, e desta forma compreender seu papel de agentes promotores de saúde e SAN.

Strategies for designing and developing services for manufacturing firms

Product/service-systems (PSS) are in effect an approach to designing integrated products and services with a focus on both customer and product life cycle activities. A range of service-oriented design strategies can be found in current literature, from product-oriented DfX approaches to more customer-oriented approaches, such as integrated solutions. In this article, design strategies related to different types of services are mapped. Case studies from two industrial companies are used to confront the existing literature in order to improve the understanding of how manufacturing companies may align their product and service development activities with their business strategies. © 2010.

Claude McKay and the transnational novel

This thesis considers the three works of fiction of the Jamaican author Claude McKay (1889-1948) as a coherent transnational trilogy which dramatises the semi-autobiographical complexities of diasporic exile and return in the period of the 1920s and 1930s. Chapter One explores McKay’s urban North American novel, Home to Harlem (1928). I suggest that we need to ‘reworld’ conceptions of McKay’s writing in order to release him from his canonical confinement in the Harlem Renaissance. Querying the problematics of the city space, of sexuality and of race as they emerge in the novel, this chapter considers McKay’s percipient understanding of the need to reconfigure diasporic identity beyond the limits set by American nationalism. Chapter Two engages with McKay’s novel of portside Marseilles, Banjo (1929), and considers the homosocial interactions of the vagabond collective. A comparison of North America and France as supposed exemplars of individual liberty highlights the unsuitability of nationalistic prerogatives to an internally diverse black diaspora. Paul Gilroy’s Black Atlantic construct provides a suggestive space in which to re-imagine the possibilities of affiliation in the port. The latter section of the chapter examines McKay’s particular influence on, and relationship, to the Négritude movement and Pan-African philosophies. Chapter Three focuses on McKay’s third novel, Banana Bottom (1933). I suggest here that the three novels comprise a coherent New World Trilogy comparable to Edward (Kamau) Brathwaite’s trilogy, The Arrivants. This chapter considers both the Caribbean and the transnational dimensions to McKay’s work.

Towards the design of a portal framework for web services integration

Web services based systems have recently found their way into many applications such as e-commerce, corporate integration and e-learning. Construction of new services or introducing new functions to existing services requires composition of web services. Current approaches to service composition often require major programming effort; this is time consuming and requires considerable developer expertise. In this paper, we explore the real and rich scenarios found in e-learning where education services are offered through the Internet by networked universities to potentially millions in the world. These services are derived from existing/emerging business operation processes and commonly offered through a web interface, combined with other services such as email and ftp services, to support partial/full business processes. We identify the requirements for a generic portal framework for easy integration of existing expertise and services of individual institutions (enterprises). We examine the existing technologies and standards, and point out the gaps to be filled in designing the architecture of the framework

Oceans and Human Health (OHH): a European Perspective from the Marine Board of the European Science Foundation (Marine Board-ESF)

The oceans and coastal seas provide mankind with many benefits including food for around a third of the global population, the air that we breathe and our climate system which enables habitation of much of the planet. However, the converse is that generation of natural events (such as hurricanes, severe storms and tsunamis) can have devastating impacts on coastal populations, while pollution of the seas by pathogens and toxic waste can cause illness and death in humans and animals. Harmful effects from biogenic toxins produced by algal blooms (HABs) and from the pathogens associated with microbial pollution are also a health hazard in seafood and from direct contact with water. The overall global burden of human disease caused by sewage pollution of coastal waters has been estimated at 4 million lost person-years annually. Finally, the impacts of all of these issues will be exacerbated by climate change. A holistic systems approach is needed. It must consider whole ecosystems, and their sustainability, such as integrated coastal zone management, is necessary to address the highly interconnected scientific challenges of increased human population pressure, pollution and over-exploitation of food (and other) resources as drivers of adverse ecological, social and economic impacts. There is also an urgent and critical requirement for effective and integrated public health solutions to be developed through the formulation of politically and environmentally meaningful policies. The research community required to address "Oceans & Human Health" in Europe is currently very fragmented, and recognition by policy makers of some of the problems, outlined in the list of challenges above, is limited. Nevertheless, relevant key policy issues for governments worldwide include the reduction of the burden of disease (including the early detection of emerging pathogens and other threats) and improving the quality of the global environment. Failure to effectively address these issues will impact adversely on efforts to alleviate poverty, sustain the availability of environmental goods and services and improve health and social and economic stability; and thus, will impinge on many policy decisions, both nationally and internationally. Knowledge exchange (KE) will be a key element of any ensuing research. KE will facilitate the integration of biological, medical, epidemiological, social and economic disciplines, as well as the emergence of synergies between seemingly unconnected areas of science and socio-economic issues, and will help to leverage knowledge transfer across the European Union (EU) and beyond. An integrated interdisciplinary systems approach is an effective way to bring together the appropriate groups of scientists, social scientists, economists, industry and other stakeholders with the policy formulators in order to address the complexities of interfacial problems in the area of environment and human health. The Marine Board of the European Science Foundation Working Group on "Oceans and Human Health" has been charged with developing a position paper on this topic with a view to identifying the scientific, social and economic challenges and making recommendations to the EU on policy-relevant research and development activities in this arena. This paper includes the background to health-related issues linked to the coastal environment and highlights the main arguments for an ecosystem-based whole systems approach.

Coastal Zone Ecosystem Services: From science to values and decision making; a case study

This research is concerned with the following environmental research questions: socio-ecological system complexity, especially when valuing ecosystem services; ecosystems stock and services flow sustainability and valuation; the incorporation of scale issues when valuing ecosystem services; and the integration of knowledge from diverse disciplines for governance and decision making. In this case study, we focused on ecosystem services that can be jointly supplied but independently valued in economic terms: healthy climate (via carbon sequestration and storage), food (via fisheries production in nursery grounds), and nature recreation (nature watching and enjoyment). We also explored the issue of ecosystem stock and services flow, and we provide recommendations on how to value stock and flows of ecosystem services via accounting and economic values respectively. We considered broadly comparable estuarine systems located on the English North Sea coast: the Blackwater estuary and the Humber estuary. In the past, these two estuaries have undergone major land-claim. Managed realignment is a policy through which previously claimed intertidal habitats are recreated allowing the enhancement of the ecosystem services provided by saltmarshes. In this context, we investigated ecosystem service values, through biophysical estimates and welfare value estimates. Using an optimistic (extended conservation of coastal ecosystems) and a pessimistic (loss of coastal ecosystems because of, for example, European policy reversal) scenario, we find that context dependency, and hence value transfer possibilities, vary among ecosystem services and benefits. As a result, careful consideration in the use and application of value transfer, both in biophysical estimates and welfare value estimates, is advocated to supply reliable information for policy making.

Energy production and ecosystem services

Ecosystems provide a range of goods and services that contribute toward human well-being. It is increasingly recognized that factors such as a growing and increasingly affluent world population, coupled with increased globalization of trade, are significantly influencing the delivery of ecosystem goods and services. This chapter argues that future energy policy must be designed based on a broad set of environmental and social considerations that examine the national and international implications of each energy technology. This approach ensures a more holistic overview of the costs and benefits associated with energy production, allowing society to make more informed choices about their futures, including how their energy is sourced, generated, and delivered.